In Australia almost one in four women undergo surgery for pelvic organ prolapse. In many other countries the rates are higher. Each year in the USA approximately 200,000 women undergo pelvic organ prolapse surgery. Pelvic organ prolapse generally involves the descent of the uterus, the bladder or the rectum along the vagina towards (or in extreme cases protruding beyond) the introitus. Women of advancing years or those that have borne several children are more frequent sufferers of pelvic organ prolapse.
Traditional vaginal surgery is associated with a high failure rate. It is between 30-40%. Complex and elaborate abdominal, vaginal and laparoscopic procedures such as abdominal sacral colpopexy, transvaginal sacrospinous ligament fixation and laparoscopic sacral colpopexy have been developed to reduce the risk of prolapse recurrence. Unfortunately these procedures require a high level of surgical expertise and are only available to a small number of specialist practitioners and therefore to a small number of patients. Details of various procedures currently in use are described in Boyles S H., Weber A M, Meyn L.—“Procedures for pelvic organ prolapse in the United States”, 1979-1997. American Journal of Obstetric Gynaecology 2003, 188; 108-115.
More recently there has been a trend towards the use of reinforcing materials to support a vaginal wall damaged by prolapse. Prosthetic materials such as donor fascia lata, pig dermis and various types of synthetic mesh have been utilized with mixed success. These materials are generally positioned under the vaginal wall or walls and sutured into position. The applicant has recognized that the synthetic meshes currently in use are far from ideal as they have been designed principally for the treatment of anterior abdominal wall herniation and are generally too heavy for the treatment of genital prolapse. Some of the meshes in current use are associated with long term problems which include pain with sexual intercourse, erosion of the mesh into the lumen of the vagina (this requires surgery to remedy) and shrinkage of the mesh.
It is an object of the present invention to provide a simplified surgical procedure suitable for treatment of different forms of pelvic organ prolapse. It is a further object to provide an improved prosthetic material and device suitable for use in vaginal repair in the treatment of pelvic organ prolapse.